Shuddering + We need HELP!

Hello, we are new to the site. I have attached my photo.
I am reaching out with several questions and concerns
and appreciate your feedback and suggestions.
If you are permitted to email me directly,
my email is: pearlhope2018@gmail.com.
Thank you for all your help!
Gratefully,
Barbara, Sweetheart's mom


Sweetheart is a male cat about 15 years old.
He was diagnosed with diabetes about 5 years ago.
I give him 3 units of lantus twice a day.

1. For the past 2 months he will shudder. It is
sporadic/random throughout the day. Does anyone
have suggestions or experience with this
kind of behavior?

2. I use the Alpha Trak for his glucose curves but
only test every 3 months according to the Vet.
She felt his numbers were OK and to continue
the 3 units 2x/day.

Here is SH's recent curve taken on 6/10/18.
1. 8:45 AM - 227
2. 11:45 AM - 262
3. 1:45 PM - 280
4. 4:00 PM - 307
5. 6:00 PM - 288
6. 8:51 PM - 234

3. I would appreciate any feedback on the best
diet for diabetic cats. SH has been on Purina
DM and Hills MD and then a variety of wet
foods from the local pet store.

4. Does anyone have suggestions for the
best litter? I have been using Pine pellets
and Pine clumping by Petsmart brand
Exquiscat. However, recently I saw on
the bag a warning. the product can "expose you to
wood dust which is a chemical known to the state of
CA to cause cancer." : (

5. SH had PU back in 2005 and is prone to
Urinary Infections (UTI). I did a culture and
here is the feedback from his Vet. If you
have suggestions, please let me know, thanks!

She wrote:
"I have SH's urine culture back from the lab. Unfortunately, there is some bad news with it. The results showed that SH has a staph bacterial infection that is showing resistance to most of the commonly used antibiotics used to treat infections. This situation is similar to MRSA bacteria that people get.

I do think that since SH has had so many UTIs, the bacteria are developing a resistance pattern due to the antibiotics we have used in the past.

In these situations, if the cat is asymptomatic (i.e. not urinating outside the litter box, not straining on urination, no blood in the urine) I do consider NOT treating these cats. The concern is if we continue to treat with this resistance pattern, there is a chance the bacteria will continue to become resistant to the few antibiotics we have left. In these situations, sometimes we create more harm than good in treating. If SH were then to every need antibiotics because he is showing symptoms, we may not have any good options left to treat him if the bacteria continues to become resistant."

Last edited: Today at 9:26 AM
Male, Sweetheart, age: 15 , weight: 14.9 lbs. Diabetic, Date 2010, Lantus, 3 units 2x/day, Alph Trak 2
Prescription Purina DM and Hill's MD, Has a PU, from 2005, prone to UTI, not currently being treated but has an infection. Vet concerned he will be resistant to antibiotics if we keep treating it.
Has no symptoms from UTI, Shudders throughout his little body random.

 

Congratulations on home testing ! Is good that you are testing but to really make sure he's ok you will need to test at least before every shoot, that way you know is safe and won't risk a hypoglicemic episode which can be really dangerous even fatal.

Since you are using Lantus here's a link where you can find a lot of good information that will help you http://www.felinediabetes.com/FDMB/...the-basics-new-to-the-group-start-here.18139/

You could also take a look at the Lantus protocols that are Start Low go Slow ( SLGS) (http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/) and Tight regulation (TR) (http://www.felinediabetes.com/FDMB/threads/lantus-levemir-tight-regulation-protocol-tr.1581/) and decide which one suits you better

Without much data is hard to say how he's doing, it will help a lot so that you can know what really is going on if you could start testing every day and recording the information, but looking at this curve it would appear he needs a little increase in his dose because this numbers are a little bit high increments would be made in 0.25 units

Diabetic cats need low carbohydrate (low carb) high protein wet food to help getting their blood glucose numbers lower, kind of like diabetic people having to avoid sugar in their food, both Purina DM and Hills MD are high carb food so they may be causing his numbers to raise a little, maybe you could consider changing him to a low carb food, here's the link to an amazing list where you could find one that suits you and that he likes (sometimes is hard to make a cat accept a new food so you may need to try more than one) (http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf) look for one that is 10% carb or less, a lot of people here use Fancy Feast classic.

Did the vet mention what specific staph he has? , maybe if you could post the results someone here can take a look at them and make some suggestions.

UTI in diabetic cats is usually hard to treat because the sugar in their urine makes a very good media for bacteria and virus to grow, what most people do (my vet included ) is give them a long treatment with antibiotics at least a month depending on the one you are using it could be 1 week rest one week then another week of antibiotic or maybe even continuously (this you would need to check with your vet ), then wait for 15 days and do another culture to see if he doesn't need another round of antibiotics.

I don't think leaving a UTI untreated is a good idea because it will probably get worse and cause more serious complications and any infection will impact his blood sugar levels.

In my case I give my kitties D-mannose to help prevent UTI's but it doesn't work with all types of bacteria, and I use it only as a prevention method I wouldn't use it instead of meds once they have the UTI

I don't know about the shudders maybe someone else will take a look and can help

 

Does the shuddering look like the skin on the back or sides is rolling or rippling?

 

Hi,
I wanted to second what Veronica's posted above and to add that the dry food isn't good not only due to high carbs content - there are more dangers to it espcially for the UTI prone kitty.
HERE is good write up by Dr. Lisa Pierson.
"Feeding dry (water-depleted) food contributes significantly to urinary tract dieases." - from HER Blog.

3 units is rather a large dose and giving it without knowing the preshot BG level is risking Hypoglycemia. I wonder if his shuddering is a Hypo symptom..? HERE is the link to the Sticky Note on the subject.

 

I am going to tag @Stephanie & Quintus

She is the only one I have seen here that has written anything like what you are describing (shuttering). I don't remember what it was (Or if there was a dx) but I do remember she posted a video.

I would pursue more option on the UTI dx. Maybe an internist or specialist.

 

Google feline hyperesthesia

 

I've had both a dog and a cat who suffered from chronic, multi-drug-resistant UTIs. Neither were diabetic, but the dog had a mass in her bladder that made her susceptible and the cat had 5 or so urinary blockages that culminated in incontinence and permanent nerve damage.

We ALWAYS treated UTIs. We worked closely with veterinarians from the university vet school to brainstorm solutions and treatment protocols. And yes, at one point the dog developed a UTI that was resistant to just about everything other than a highly kidney-toxic drug and one that is a "drug of last resort" and primarily reserved for human use only.

Given the grave nature of where we were heading (and the potential risk of some of the bugs to we humans), we experimented a lot to try to prevent them. In the end, both were on Cosequin (there's evidence it helps the bladder walls) and long-term broad spectrum antibiotics. After we cleared her last, and most scary, UTI, the dog stayed on a low-dose of clavamox daily for the rest of her life and never developed another UTI. That was after 3 years of nearly constant UTIs which worsened each time. She was also on a form of cranberry extract.

The cat gave me fits for several years as well with frequent UTIs and even developed a suspected kidney infection. He too was on broad-spectrum antibiotics for quite some time but we managed to finally get over the hump and he has been doing well for several years now. He never had the PU surgery (wouldn't have solved his particular problem) but his incontinence and eventual inability to urinate at all without having his bladder manually expressed meant we had a constant battle with stagnant urine in his bladder.

I would never opt not to treat unless I were throwing in the towel. However, you might need to stay on drugs longer, combine multiple drugs simultaneously (we had to do that a few times), and look into additional supplements. I'd also strongly encourage you to focus on regular home monitoring of blood glucose so that you can better control the diabetes. All that glucose in the urine is a prime breeding ground for bacteria. The vet may be happy with the numbers, but you have a special situation with these MDR UTIs so I'd be doing everything possible to collect blood glucose data and more closely manage his insulin dosing. You might also want to toss the dry food.

As for the shuddering ... When was the last time he had a full blood panel? I'd do that if you haven't recently. I'd also check his BG when he's having an episode to rule out a hypo or to see if he's exceedingly high. How do his pupils look when this is happening? Has anyone checked his temperature? And finally, I'd consider a blood pressure check for good measure.

 

Is it a full body shutter or just legs?